Leadership Education for Asian Pacifics, Inc.

LEAP
327 E. 2nd Street,
Suite # 226
Los Angeles, CA 90012
Phone: (213) 485-1422
FAX: (213) 485-0050
Email: leap@leap.org

Executive Directors Leadership Program

Please complete this registration form. You will enter your payment information on the next page if paying by credit card.

* indicates a required field

First Name	* M.I.
Last Name	*
Address 1	*
Address 2
City	*
State	*
Zip	*
Phone	* 888-888-8888
Email	*
Organization/Company/School
Sector	If other, please list
Ethnic Heritage
Generation
* How did you hear about this event?	LEAP Mailing/Brochure Conference Committee LEAP E-Newsletter Colleague Website Friend/Family Other If other, please list
Dietary Restrictions:
*Number of Years Served as an Executive Director:
*Organizational Budget Size:
Lodging Dates - Part 1: (optional)	Check in: Check out is November 2, 2008.
Lodging Dates - Part 2: (optional)	Check in: Check out is March 18, 2009.
Please select your method of payment:*
Credit Card [via secure online payment after submitting this form]	Check [mailing information on the next page]	Invoice [invoice information on the next page]
*Please note you will need to submit the following to Reimar Macaranas via email at: rmacaranas@leap.org or via fax at: (213) 485-0050. Letter of endorsement from you Board Chair Personal statement regarding work experience as related to your role as Executive Director (500 words maximum) Brief description of what you would like to gain from this program (500 words maximum) Thank you for your registration! Please click on the "submit" button below to complete the process.